The prognostic value of the physical examination in patients with chronic heart failure

Congest Heart Fail. 2003 May-Jun;9(3):170-5, 178. doi: 10.1111/j.1527-5299.2003.01341.x.

Abstract

The importance placed on the physical examination in the assessment of patients with cardiovascular disorders appears to be declining, perhaps in part due to a paucity of data showing its value in the modern era. To determine whether the physical examination provides important prognostic information in patients with chronic heart failure, the authors performed a post-hoc analysis of 2479 participants from the Studies of Left Ventricular Dysfunction (SOLVD) treatment trial. The presence of elevated jugular venous pressure and a third heart sound at baseline were each associated with subsequent heart failure hospitalization, the composite end point of death or heart failure hospitalization, and pump-failure death, independently of many other markers of disease severity. The subgroup of patients with at least one of these two physical examination findings was at increased risk for all-cause mortality. The authors believe that additional studies assessing the prognostic value of the physical examination should be conducted and, if favorable, likely would lead to a renewed interest in the physical examination.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiac Output
  • Heart Failure* / diagnosis
  • Heart Failure* / mortality
  • Heart Failure* / physiopathology
  • Heart Sounds
  • Hemodynamics
  • Humans
  • Multivariate Analysis
  • Physical Examination*
  • Prognosis
  • Valsalva Maneuver